Here’s hoping the 4th July 2011 will go down in history. The day that Andrew Dilnot made successful recommendations for long term care reform, that the Government accepted, took forward in legislation and were implemented with pace.
We have a long way to go before we can claim success, but Dilnot’s proposals for reform are a good start towards this goal.
Andrew Dilnot was given the unenviable task of proposing recommendations which would create a better care system, one which was more sustainable, fair, easier to understand and affordable. He has worked meticulously, gathering evidence, statistics, views from the general public and from stakeholders such as Age UK. In subsequent blogs I will look at each of the tests in more detail, but here are some initial reactions to his proposals:
1. We welcome that Dilnot has called for more national funding – between £1.3bn and £2.2bn. Without investment in social care any reform will not be sustainable and is liable to run into future difficulties. We have repeated throughout this process that the Government cannot afford not to reform care, and that by investing in better essential services the Government will save more in health, housing and welfare interventions. We know there will be a big debate about where this money comes from, but these issues can be answered.
2. We also welcome the increased certainty this package of proposals sets out. Whilst £35k is not insubstantial, the reality is that many people pay more than this currently for their care, and those that don’t are fearful they might have to. What the cap does is take the guessing game out of care and encourages people to plan ahead and to think about their future. It’s one of the big disincentives in the current system and the cap will remove this.
3. One of the biggest surprises of today’s report is the increase to the means test threshold from £23,250 to £100,000. This is good news for many people, easing the concern about leaving assets as inheritance and the frustration of using assets for care fees. In reality this threshold will only affect those people who need residential care, as it is a small proportion of older people who have more than £100k in savings and non-housing assets.
4. Amongst the top social care bugbears is the current variation in provision between the individual local councils. Dilnot’s recommendation for a consistent threshold is therefore very welcome. It raises issues of local finance allocation, service provision and prices, but these are for another day. What matters is that older people will be able to take an assessment and move house in confidence that their needs will continue to be met.
5. Dilnot has accepted one of the fundamental arguments on disability benefits: that they are preventative, and that in a system which, at least in the short term, will only provide for higher needs, are an important way of broadening the reach of the state to people with lower levels of need. We also agree, however, that there is a branding exercise to do on Attendance Allowance, starting with a change of name to make its purpose clearer. But this is cosmetic, and we’re pleased that disability benefits will remain.
It’s also important to remember that funding is only one piece of the puzzle. We have a challenge ahead to improve the quality of care so that it is consistent and reliable. We also need to foster transformational change so that care services are prioritised, recognised as essential and given their due. Without tackling poor quality and creating better ways of providing services we will not be successful in achieving our goal of better care.
So what next? Other than continuing to read and digest the detail, share concerns and celebrate the good bits? Our attention turns to the Government, who in commissioning this report laid itself open to calls of subsequent action. We have all heard the political rumours last week that particular parts of the Cabinet are concerned about the proposals. However, we must press on in good faith that the groundswell of opinion on care reform will be so great that it cannot be ignored, and that the Government feels compelled to act. Age UK and other stakeholders have a role to play in helping shape the ensuing debate and supporting older people to campaign and lobby their MPs.
Watch this space for more detailed thoughts on the proposals.